학술논문
Optimizing the World Health Organization algorithm for HIV vertical transmission risk assessment by adding maternal self-reported antiretroviral therapy adherence
Document Type
article
Author
Sheila Fernández-Luis; Maria Grazia Lain; Miquel Serna-Pascual; Sara Domínguez-Rodríguez; Louise Kuhn; Afaaf Liberty; Shaun Barnabas; Elisa Lopez-Varela; Kennedy Otwombe; Siva Danaviah; Eleni Nastouli; Paolo Palma; Nicola Cotugno; Moira Spyer; Viviana Giannuzzi; Carlo Giaquinto; Avy Violari; Mark F. Cotton; Tacilta Nhampossa; Nigel Klein; Nastassja Ramsagar; Anita Janse van Rensburg; Osee Behuhuma; Paula Vaz; Almoustapha Issiaka Maiga; Andrea Oletto; Denise Naniche; Paolo Rossi; Pablo Rojo; Alfredo Tagarro; EPIICAL Consortium
Source
BMC Public Health, Vol 22, Iss 1, Pp 1-9 (2022)
Subject
Language
English
ISSN
1471-2458
Abstract
Abstract Background The World Health Organization (WHO) risk assessment algorithm for vertical transmission of HIV (VT) assumes the availability of maternal viral load (VL) result at delivery and early viral control 4 weeks after initiating antiretroviral treatment (ART). However, in many low-and-middle-income countries, VL is often unavailable and mothers’ ART adherence may be suboptimal. We evaluate the inclusion of the mothers’ self-reported adherence into the established WHO-algorithm to identify infants eligible for enhanced post-natal prophylaxis when mothers’ VL result is not available at delivery. Methods We used data from infants with perinatal HIV infection and their mothers enrolled from May-2018 to May-2020 in Mozambique, South Africa, and Mali. We retrospectively compared the performance of the WHO-algorithm with a modified algorithm which included mothers’ adherence as an additional factor. Infants were considered at high risk if born from mothers without a VL result in the 4 weeks before delivery and with adherence